kshar sutra

Kshar Sutra is an ancient Ayurvedic para-surgical medicated thread used primarily for the treatment of complex anorectal conditions, such as fistula-in-ano, hemorrhoids, and pilonidal sinus. The thread, typically a surgical linen thread (No. 20), is prepared through a multi-stage coating process involving the latex of *Snuhi* (*Euphorbia neriifolia*), the alkaline ash or *Kshar* of *Apamarga* (*Achyranthes aspera*), and the powder of *Haridra* (*Curcuma longa*). The mechanism of action is dual: it provides mechanical cutting of the fistulous track similar to a seton, while the chemical coating facilitates simultaneous debridement, drainage, and antiseptic action. The *Snuhi* latex contains proteolytic enzymes that assist in cutting, the *Apamarga Kshar* provides a caustic alkaline pH (around 9.2) that debrides necrotic tissue, and the *Haridra* acts as an anti-inflammatory and antiseptic agent to promote healing from the base of the wound. This modality is noted for its high success rates and significantly lower recurrence compared to conventional fistulectomy.

Other names

KsharsutraKshar Sutra LigationKSLApamarga Kshar Sutramedicated threadGuggulu Kshar Sutra